Ruck P, Horny H P, Greschniok A, Wehrmann M, Kaiserling E
Institute of Pathology, University of Tübingen, Germany.
Hematol Pathol. 1995;9(1):49-56.
It is well known that some of the widely used antibodies directed against hemopoietic antigens exhibit cross-reactivity with normal and neoplastic nonhemopoietic cells. By contrast, relatively little is known about the immunoreactivity of hemopoietic cells with antibodies that detect nonhemopoietic antigens. In this study 43 routinely processed bone marrow biopsy specimens containing infiltrates of acute leukemia of different subtypes were stained with a panel of 20 antibodies that detect nonhemopoietic antigens in formalin-fixed and paraffin-embedded tissue. Thirteen of the antibodies applied (KL1; BMA 120; and antibodies against epithelial membrane antigen, alpha-fetoprotein, prostate-specific acid phosphatase, prostate-specific epithelial antigen, placental alkaline phosphatase, alpha-amylase, serotonin, bombesin, beta-human chorionic gonadotrophin, desmin, and S-100 protein) did not stain blast cells in any of the cases. However, anti-vimentin, HMB45, and anti-myoglobin stained blast cells in the majority of the cases; the antibodies against thyroglobulin, actin, and carcinoembryonic antigen stained blast cells in 10% to 25% of the cases; and anti-neuron-specific enolase stained blast cells in less than 10% of the cases. No correlation was found between the leukemia subtype and the pattern of immunoreactivity. The staining specificity, (i.e., the specificity of binding of the primary antibody--immunologic vs. nonimmunologic binding), was tested by increasing the dilution of the primary antibody and comparing the staining intensity in the bone marrow specimens and control tissue. Staining specificity was confirmed only for staining with the antibodies against neuron-specific enolase and vimentin. The findings show that immunoreactivity of tumor cells in bone marrow biopsy specimens for nonhemopoietic antigens does not exclude a diagnosis of acute leukemia.
众所周知，一些广泛使用的针对造血抗原的抗体与正常和肿瘤性非造血细胞存在交叉反应。相比之下，关于造血细胞与检测非造血抗原的抗体的免疫反应性，人们了解得相对较少。在本研究中，用一组20种抗体对43例常规处理的骨髓活检标本进行染色，这些抗体可检测福尔马林固定、石蜡包埋组织中的非造血抗原，这些标本含有不同亚型急性白血病的浸润。所应用的13种抗体（KL1；BMA 120；以及抗上皮膜抗原、甲胎蛋白、前列腺特异性酸性磷酸酶、前列腺特异性上皮抗原、胎盘碱性磷酸酶、α淀粉酶、5-羟色胺、蛙皮素、β-人绒毛膜促性腺激素、结蛋白和S-100蛋白的抗体）在任何病例中均未对原始细胞进行染色。然而，抗波形蛋白、HMB45和抗肌红蛋白在大多数病例中对原始细胞进行了染色；抗甲状腺球蛋白、肌动蛋白和癌胚抗原的抗体在10%至25%的病例中对原始细胞进行了染色；抗神经元特异性烯醇化酶在不到10%的病例中对原始细胞进行了染色。未发现白血病亚型与免疫反应模式之间存在相关性。通过增加一抗的稀释度并比较骨髓标本和对照组织中的染色强度，测试了染色特异性（即一抗结合的特异性——免疫结合与非免疫结合）。仅针对抗神经元特异性烯醇化酶和波形蛋白的染色证实了染色特异性。研究结果表明，骨髓活检标本中肿瘤细胞对非造血抗原的免疫反应性并不排除急性白血病的诊断。
